Diabetes in Old Age

Edited byAlan J. Sinclair, Foundation for Diabetes Research in Older People, Diabetes Frail Ltd and University of Aston, UK Trisha Dunning, Centre for Nursing and Allied Health Research, Deakin University and Barwon Health, Geelong, Australia Leocadio Rodríguez Mañas, Servicio de Geriatría, Hospital Universitario de Getafe and Universidad Europea de Madrid, Spain Medha Munshi, Joslin Geriatric Diabetes Programs, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, USA

• Preface viiForeword viiiList of Contributors xiSection A: Pathophysiology, screening and diagnosis 11 Pathophysiology of diabetes in older people 3Graydon S. Meneilly2 Type 1 diabetes in older age 13Medha Munshi and Alan J. Sinclair3 Preventative strategies 20Edward S. Horton4 Diagnosis and screening 29Jorge Manzarbeita5 Assessment procedures including comprehensive geriatric assessment 43Willy Marcos Valencia, Marie Danet, and Hermes FlorezSection B: Vascular risk factors and complications 556 Peripheral arterial disease 57Leocadio Rodríguez Mañas, Cristina Alonso Bouzon, and Marta Castro Rodríguez7 Coronary heart disease 67Ahmed H. Abdelhafiz8 Chronic kidney disease related to diabetes in older patients 84Isaac Sinay and Felipe Inserra9 Visual loss in people with diabetes in old age 106Peter H. Scanlon10 Diabetes foot disease 113Srikanth Bellary11 Diabetes, neuropathy, and old age 125Jennifer Dineen and Christopher Gibbons12 Sensory disabilities in people with diabetes 137Rowan Hillson13 Sexual health and wellbeing 148Geoffrey I. Hackett14 eHealth and diabetes: Designing a novel system for remotely monitoring older adults with type 2diabetes 167Elena Villalba‐Mora, Ignacio Peinado‐Martínez, and Francisco del PozoSection C: Treatment and care issues 17715 Insulin resistance and the metabolic syndrome 179Andrew J. Krentz and Angelo Scuteri16 Diabetes and functional limitation: The emergence of frailty and disability 213Leocadio Rodriguez Manas and Alan J. Sinclair17 Metabolic decompensation in older people 225Giuseppe Paolisso and Michelangela Barbieri18 Nutrition management 240Trisha Dunning19 Physical exercise management 267Mikel Izquierdo and Eduardo Lusa Cadore20 Medicines, pharmacovigilance, and the importance of undertaking comprehensive assessmentsand regular medicine reviews 277Trisha Dunning21 Glucose‐lowering drugs 298Andrew J. Krentz and Alan J. Sinclair22 Insulin therapy 323Ahmed H. Abdelhafiz23 Hypertension in older diabetic patients 338N. Jain, A. Chikara, and A. Goel24 Hypoglycemia 350Medha Munshi25 Diabetes in care homes 360Trisha Dunning and Alan J. Sinclair26 Primary and community care of diabetes in older people 376Mark Kennedy27 Inpatient diabetes care and admissions avoidance in older people with diabetes 395Belinda Allan, Ketan Dhatariya, Esther Walden, Carol Jairam, and Mike SampsonSection D: Management of associated complications 41128 Diabetes and co‐morbidities 413Marta Castro Rodríguez and Leocadio Rodríguez Mañas29 Diabetes and cognitive dysfunction 426Alan J. Sinclair30 Mood disorders 437Ahmed H. Abdelhafiz and Alan J. Sinclair31 Falls and diabetes 448Cristina Alonso Bouzón and Medha Munshi32 Managing pain 456Trisha Dunning33 Palliative and end‐of‐life care 470Trisha Dunning and Alan J. SinclairSection E: Optimizing diabetes care in older people 48934 Diabetes education and the older adult 491Elizabeth A. Beverly, Arlene Smaldone, and Katie Weinger35 Supporting the family and informal carers 505Alan J. Sinclair and Trisha Dunning36 Public health issues and community impact 516Luis Miguel Gutiérrez Robledo and Roger Gadsby37 Providing cost‐effective diabetes care 525Chia‐Hung Chou and Elbert S. Huang38 Clinical trials in older people 533Olga Laosa, Marta Checa, and Laura PedrazaIndex 543